Hazard monitor for surgical tourniquet systems

ABSTRACT

A hazard monitor for surgical tourniquet systems comprises: pressure transducing means for detecting a pressure in a pneumatic tourniquet cuff; power switch means for enabling an operator in initiate an interruption in the supply of electrical power required by pressure regulator means, wherein the tourniquet instrument is connectable pneumatically to the tourniquet cuff to supply pressurized gas to the cuff, thereby producing a pressure in the cuff; pneumatic connector means for enabling an operator to connect an inflatable cuff to the pressure regulator means, and hazard detection means communicating pneumatically with the pneumatic connector means for detecting pressurized gas having a pressure greater than a predetermined pressure level when an interruption in the supply of electrical power is initiated by the operator.

FIELD OF THE INVENTION

This invention relates generally to an apparatus and method formonitoring a surgical tourniquet system to detect a hazard. Theinvention relates more particularly, but not by way of limitation, to ahazard monitor having means to detect that a pneumatic cuff of anelectrically powered surgical tourniquet system is pressurized whenelectrical power required for operation of one or more components of thesystem is not supplied to the components, and to detect whether the cuffis pressurized when an operator attempts to interrupt the supply of theelectrical power required for the operation of the system.

BACKGROUND OF THE INVENTION

Surgical tourniquet systems are commonly used facilitate surgery bystopping the flow of arterial blood into a limb for a period of timesufficient for the performance of a surgical procedure, thereby allowingthe surgical procedure to be performed in a dry and bloodless surgicalfield.

Published medical literature indicates that every usage of a surgicaltourniquet necessarily causes some injury to the nerve, muscle and softtissue in the limb beneath the cuff and distal to the cuff. To minimizethe nature and extent of such injuries, tourniquet operators attempt tominimize the level of cuff pressure employed to establish and maintain abloodless surgical field distal to the cuff. Also to minimizetourniquet-related injuries, tourniquet operators attempt to minimizethe duration of tourniquet cuff pressurization. Cuff pressurization foran unnecessarily long period of time is hazardous because it is wellestablished in the medical literature that the probability and severityof tourniquet-related injury to a patient's limb increase as theduration of tourniquet application increases.

Surgical tourniquet systems of the prior art generally include apneumatic cuff for encircling a patient's limb at a location proximal tothe surgical site, a source of pressurized gas and an instrumentpneumatically connected to the cuff and the source for supplying gas tothe cuff at a regulated pressure.

In some tourniquet systems of the prior art, the source of pressurizedgas is a tank or hospital gas supply, while in other prior art systemsan electrically powered air pump is integrated into the instrument. Somesurgical tourniquet instruments known in the prior art incorporateelectrically powered components including electronic pressuretransducers, microprocessors, displays and audiovisual alarms. Althougha few types of prior-art surgical tourniquet instruments having noelectrically powered components are still in use, most of the surgicaltourniquet instruments in common use at present are electrically poweredin whole or in part.

One type of tourniquet instrument known in the prior art that ispartially powered by electricity is the Electromedics TCPM TourniquetCuff Pressure Monitor (Electromedics Inc., Englewood, Colo.). Thisinstrument includes an electrically powered display component fordisplaying the cuff pressure set by an operator, an electrically poweredelapsed time clock to allow an operator to monitor cuff inflation time,a non-electrical pneumatic switch component for allowing an operator toinflate and deflate the cuff, and a non-electrical pressure regulatorfor supplying gas to the cuff at a pressure near the set pressure. Anelectrical power switch on the instrument controls the supply of powerto the electrical components from a battery within the instrument whenan operator turns on an electrical power switch on the instrument. TheElectromedics instrument does not incorporate an electrically poweredpump and instead requires that either a gas tank or a centralizedhospital gas supply be employed as the source of pressurized gas.

The prior-art Electromedics instrument is designed so that, when apressurized tourniquet cuff is no longer required near the end of asurgical procedure, an operator can first deflate the cuff using thenon-electrical pneumatic switch component and the operator can then turnoff power to the electrical components by using the electrical powerswitch. However, if an operator erroneously turns off the electricalpower at some point during a surgical procedure and does notdepressurize the cuff by using the separate pneumatic switch, then thecuff remains pressurized near a pressure regulated by the non-electricalpressure regulator while the electrical pressure display is unpoweredand blank. This error may create a serious hazard for the patient if anuntrained or inexperienced operator erroneously assumes that the cuffhas been deflated because the pressure display is blank, and as a resultthe cuff remains pressurized for an extended period of time. Cuffpressurization for an unnecessarily long period of time is hazardousbecause it is well established that the probability and severity oftourniquet-related injuries to a patient's limb increase as the durationof tourniquet application increases.

A tourniquet instrument known in the prior art that is completelypowered by electricity is that of McEwen as described in U.S. Pat. No.B1 4,469,099, which is herein incorporated by reference. McEwen '099describes a surgical tourniquet system that includes both an instrumentthat is electrically powered and an electrically powered air pumpincorporated into the instrument as the source of pressurized gas.McEwen '099 is operable from power supplied by an external AC supplysupplemented by an internal battery and includes the followingelectrically powered components: an operator interface for allowing anoperator to set the tourniquet cuff pressure and the anticipated periodof time of cuff pressurization; switches to allow the operator toinitiate pressurization and depressurization of the cuff; a cuffpressure display for allowing the operator to set the cuff pressure andmonitor the actual cuff pressure; a microprocessor-controlled pressureregulator for regulating the cuff pressure near the set pressure; and atime display for allowing the operator to specify a surgical time andmonitor the elapsed time during which the cuff has been pressurized.

McEwen '099 also includes a variety of electrically powered audiovisualalarms for warning the operator of certain hazardous conditions that mayexist during operation, including warning of any cuffover-pressurization, cuff under-pressurization or an excessive period ofcuff pressurization. If the external AC power supply to McEwen '099 isunexpectedly interrupted while the cuff is pressurized, the internalbattery continues to provide power to the displays and alarms but thepressure regulator ceases operation and pneumatic valves in theinstrument seal off the pressurized cuff to retain the pressure in thecuff for as long as possible or until external AC power is restored andnormal operation can resume. Thus in the event of an interruption ofexternal AC power during use in surgery, McEwen '099 prevents hazardsfor the patient such as the unanticipated flow of arterial blood intothe surgical field during a procedure, the loss of large amounts ofblood, and in some cases the loss of intravenous anesthetic agentretained in the limb distal to the cuff. However, an unusual type ofhazard may arise if the operator erroneously turns off the electricalpower switch of the instrument without first deflating the tourniquetcuff, and then does not pneumatically disconnect the cuff from theinstrument and remove the cuff from the patient's limb for an extendedperiod of time. Turning off the electrical power switch of McEwen '099interrupts the supply of electrical power from both the external ACsupply and the internal battery. Thus in the event of such operatorerrors, without the supply of any electrical power, the cuff pressuredisplay and the time display of McEwen '099 go blank and the audiovisualalarms are not functional, and an untrained or inexperienced operatormay erroneously assume that the cuff has been deflated because thedisplays are blank. McEwen '099 does not produce an audiovisual alarm toalert the operator to the hazard that the tourniquet cuff might remainpressurized and apply pressure to the patient's limb for a prolongedperiod of time after interruption of the electrical power to thetourniquet instrument.

Other surgical tourniquet systems known in the prior art are entirelypowered from an external AC power supply and have no internalsupplementary battery as in McEwen '099. In the event of an interruptionof power to these other prior-art systems during surgery, such as mightarise from a disconnection of the AC supply or an operator error, anypressure and time displays included in such instruments go blank, anyaudio-visual alarms are non-functional, and the pressurized cuff issealed off pneumatically to prevent the above-mentioned types of hazardsthat would otherwise arise for the patient if the cuff were toimmediately depressurize upon power interruption. However, none of theseprior-art systems produce an audiovisual alarm to alert the operator tothe hazard that the tourniquet cuff might remain pressurized for aprolonged period of time after power interruption.

Some prior-art tourniquet instruments have a “soft” electrical powerswitch, typically implemented as a momentary contact membrane switch ora low current momentary pushbutton switch. Such a “soft” electricalpower switch does not directly control the supply of electrical power tothe operational components of the tourniquet instrument but acts tocontrol other electrical components that directly control the supply ofelectrical power required for operation of the tourniquet instrument.For example, each of the prior-art A.T.S. 2000 and A.T.S. 750 tourniquetinstruments manufactured by Zimmer Patient Care Division (Dover, Ohio)includes a “soft” electrical power switch which produces an interruptionof electrical power required for operation of the instrument only afterthe operator has initiated the power interruption by actuating the“soft” power switch.

No surgical tourniquet system or monitoring apparatus is known in theprior art that can detect the presence of a pressurized pneumatic cuffof a surgical tourniquet system when electrical power required forproper operation of the surgical tourniquet system is not supplied tothe system. Furthermore, no electrically powered tourniquet instrumentis known in the prior art that can prevent an operator from interruptingthe supply of the electrical power required for the operation of thetourniquet instrument if the operator initiates an interruption of theelectrical power while a pneumatic cuff connected to the tourniquetinstrument is pressurized.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a pictorial representation and block diagram of the preferredembodiment in a surgical application.

FIG. 2 is a circuit schematic of the preferred embodiment.

FIG. 3 is a circuit schematic of an embodiment of the invention adaptedfor use with tourniquet instruments that have a soft power switch.

DESCRIPTION OF THE PREFERRED EMBODIMENT

The preferred embodiment illustrated is not intended to be exhaustive orlimit the invention to the precise form disclosed. It is chosen anddescribed in order to explain the principles of the invention and itsapplication and practical use, and thereby enable others skilled in theart to utilize the invention.

FIG. 1 depicts hazard monitor 2 configured to monitor the pressure intourniquet cuff 4 positioned on limb 6. Tourniquet instrument 8 is usedto inflate and pressurize tourniquet cuff 4, thereby occluding bloodflow in limb 6 during surgical procedures. Tourniquet instrument 8 isconnected pneumatically to tourniquet cuff 4 via pneumatic tubing 10,pneumatic T-connector 12, and pneumatic tubing 14. Tourniquet instrument8 has a number of components that are electrically powered during normaloperation, including pressure transducer, pressure display, timedisplay, alarms and indicators.

As shown in FIG. 1, hazard monitor 2 connects pneumatically totourniquet cuff 4 via pneumatic tubing 16, pneumatic T-connector 12, andpneumatic tubing 14. In addition, hazard monitor 2 connects electricallywith tourniquet instrument 8 via electrical cable 18, in order to permithazard monitor 2 to monitor the voltage applied to an electricalcomponent within tourniquet instrument 8 that requires electrical powerfor operation, as described below.

As shown in FIG. 1, tourniquet cuff 4 communicates pneumatically withpressure transducer 20 through pneumatic tubing 16, pneumaticT-connector 12, and pneumatic tubing 14. In the preferred embodiment,pressure transducer 20 is a normally-closed single-pole single-throwpressure switch (MPL-600 Series, Micro Pneumatic Logic, Pompano Beach,Fla.); the contacts of this pressure switch open when the sensedpressure is greater than a predetermined pressure of 15 mmHg. Pressuretransducer 20 is specified for operating pressures up to 2000 mmHg, wellabove the typical maximum pressure of 450 mmHg used in normal tourniquetcuff procedures. It will be apparent to those skilled in the art that,in place of the pressure switch employed in the preferred embodiment,pressure transducer 20 may be implemented by employing an analogpressure transducer which outputs a pressure signal proportional to thesensed pressure, and that the resulting pressure signal can be comparedto a reference signal indicative of a predetermined reference pressureto detect when the sensed pressure in cuff 4 in is greater than thepredetermined reference pressure level.

In the preferred embodiment, the supply of electrical power to acomponent of tourniquet instrument 8 requiring electricity for operationis monitored by monitoring the voltage level at the component; thepreferred embodiment determines that power is not supplied to thecomponent if the monitored voltage level at the component is below apredetermined voltage level. It will be appreciated that the supply ofelectrical power to the component could alternately be monitored bymonitoring the level of current passing through the component. In thepreferred embodiment, as can be seen in FIG. 1, voltage detector 22connects via electrical cable 18 to an electrical component oftourniquet instrument 8 that requires electrical power in order fortourniquet instrument 8 to operate normally during a surgical procedure.Examples of such electrical components of tourniquet instrument 8 are: apressure transducer used for sensing the pressure in tourniquet cuff 4;a display for producing an indication for an operator of the sensedpressure in cuff 4; a pressure regulator or individual electricallypowered elements of the pressure regulator such as electro-pneumaticvalves or microprocessors; an electrical pump for generating compressedair for use by a pressure regulator, and a display for providing anoperator with an indication of the time during which pressurized gas hasbeen supplied to cuff 4 by the tourniquet instrument 8. In the preferredembodiment, voltage detector 22 monitors the voltage at any selected oneof such electrical components via electrical cable 18. When the voltageapplied to the monitored electrical component is above a predeterminedthreshold, voltage detector 22 produces a signal and when the voltage isbelow the threshold no signal is produced.

As can be seen in FIG. 1, power supply 24 supplies the electrical powernecessary for the electrically powered components in hazard monitor 2.Power supply 24 is independent of any external sources of power,including the electrical power supply found in tourniquet instrument 8.Power supply 24 is monitored by low power detector 26 which detects whenthe voltage produced by power supply 24 has fallen below a predeterminedthreshold, as described further below. In the preferred embodiment,power supply 24 is a 3 volt lithium-ion battery capable of supplyingpower to hazard monitor 2 for up to 10 years before requiringreplacement.

Low power detector 26 monitors the voltage output by power supply 24.When the voltage output by power supply 24 drops below a predeterminedthreshold required for normal operation of hazard monitor 2 and requiresreplacement, low power detector 26 produces a signal.

Alarm control 28 responds to the signals produced by low power detector26 and voltage detector 22, and to the closed or open circuit providedby pressure transducer 20, and produces an alarm signal when an alarmcondition is present. An alarm condition exists when either: (a)pressure in tourniquet cuff 4 is above the predetermined pressure of 15mmHg as sensed by pressure transducer 20 and the voltage applied to themonitored electrical component within tourniquet instrument 8 is below apredetermined threshold as sensed by voltage detector 22; (b) thevoltage output of power supply 24 is below a predetermined threshold assensed by low power detector 26. In the preferred embodiment, the alarmcondition logic is implemented via low-power CMOS logic gates. It isobvious to those skilled in the art that the alarm condition logic inalarm control 28 could be implemented in a number of ways, including theuse of a microcontroller-based system, a network of diode and transistorlogic gates, or the use of analog switches and relays.

When an alarm signal is produced by alarm control 28 the operator isalerted to the alarm condition by both audible and visual alarms viavisual indicator 30 and audible indicator 32. In the preferredembodiment, audible indicator 32 is a low-power piezoelectric pulse-tonegenerator, while visual indicator 30 is a low-powerelectromagnetically-actuated status indicator (Status Indicator Model30-ND, Mark IV Industries, Mississauga, Ontario, Canada). Visualindicator 30 is a bi-stable indicator which requires no power duringsteady-state and minimal power when changing state from inactive(reset—alarm condition not indicated) to active (set—alarm conditionindicated). In the preferred embodiment, visual indicator 30 remains inits last state indefinitely after power supply 24 has been depleted. Byoperating in this way, visual indicator 30 alerts the operator of apersisting alarm condition, such as low power in power supply 24 sensedby low power detector 26, even after power supply 24 has been fullydepleted.

When tourniquet cuff 4 is applied to a patient's limb and tourniquetinstrument 8 is supplying pressurized gas to cuff 4 during a surgicalprocedure and hazard monitor 2 is configured as shown in FIG. 1, hazardmonitor 2 senses both the voltage applied to the monitored electricalcomponent within tourniquet instrument 8 and the pneumatic pressure intourniquet cuff 4. In the event that the sensed pneumatic pressure intourniquet cuff 4 exceeds a predetermined pressure level when electricalpower is not supplied to the monitored electrical component intourniquet instrument 8, hazard monitor 2 detects this hazardouscondition and produces a alarm signal and an audio-visual alarmperceptible to the operator via visual indicator 30 and audibleindicator 32. The alarm signal continues to be produced, and both visualindicator 30 and audible indicator 32 continue to indicate the alarmcondition, until the pressure in tourniquet cuff 4 drops below thepredetermined pressure level, or until electrical power is supplied tothe component in tourniquet instrument 8.

When cuff 4 is not pressurized above the predetermined pressure level,the switch contacts of pressure transducer 20 are closed, and hazardmonitor 2 does not produce any alarm unless low power detector 26 sensesthat power supply 24 is below a predetermined minimum voltage andrequires replacement; in that event, hazard monitor 2 responds to lowpower detector 26 by producing a low-power alarm perceptible to theoperator via visual indicator 30 and audible indicator 32. Visualindicator 30 continues to produce the low-power alarm until power supply24 is replaced with another power supply having a voltage level greaterthan the predetermined minimum voltage, while audible indicatorcontinues to produce the low-power alarm until power supply 24 iscompletely depleted.

FIG. 2 is a simplified schematic diagram of the preferred embodimentthat shows the interconnections of the major components of the preferredembodiment.

Power supply 24 is a 3 volt lithium-ion battery. In FIG. 2, the positiveterminal of power supply 24 is shown labeled as Vbatt and the negativeterminal is shown connected-to the ground. Power supply 24 is connectedto voltage regulator 34, which produces a reference voltage of 1.5volts, labeled as Vref, which is used by voltage detector 22 and lowpower detector 26, as described below.

As is common practice when describing logic circuits the terms “high”and “low” are used to describe the states of signals in the followingdescription of the circuit schematic shown in FIG. 2. When a signal isdescribed has “high” its voltage is near the level of the voltageproduced by power supply 24. When a signal is described as low it has avoltage level near zero.

The normally closed electrical contacts of pressure transducer 20 areshown in FIG. 2 by the symbol for a switch. One of the switch contactsis connected to ground and the other switch contact is connected to bothhigh-impedance pull-up resistor 36 in series with Vbatt, and to one ofthe inputs of AND gate 38. When the pressure sensed by pressuretransducer 20 is less than the predetermined pressure the switchcontacts of pressure transducer 20 are in the closed position and thelevel of the signal at the input of AND gate 38 is low. When thepressure sensed by pressure transducer 24 is greater than thepredetermined pressure, the switch contacts of pressure transducer 20open and the level of the signal at the input of AND gate 38 is high.

Voltage detector 22 is comprised of analog comparator 40 andhigh-impedance resistors 42 and 44 configured as a voltage dividernetwork. The voltage signal from the monitored component withintourniquet instrument 8 is shown in FIG. 2 with the label Vtourn. Vtournas conducted by electrical cable 18 is communicated to the voltagedivider network formed by resistors 42 and 44. Analog comparator 40compares the level of the voltage-divided Vtourn signal at the junctionof resistor 42 and 44 with the level of the reference voltage Vref.Analog comparator 40 is configured so that when the level of thevoltage-divided signal from Vtourn is less than the level of Vref, thesignal level at the output of analog comparator 40 will be low. When thelevel of the voltage-divided signal from Vtourn is greater than level ofVref, the signal level at the output of analog comparator 40 will behigh. Analog comparator 40 has hysteresis to prevent oscillations in itsoutput signal when the level of the voltage-divided signal from Vtournis near the level of Vref.

Low power monitor 26 is comprised of analog comparator 46 andhigh-impedance resistors 48 and 50 configured as a voltage dividernetwork. Vbatt is connected to the voltage divider network formed byresistors 48 and 50. Analog comparator 46 compares the level of thevoltage-divided Vbatt signal at the junction of resistor 48 and 50 withthe level of the reference voltage Vref. Analog comparator 46 isconfigured so that when the level of the voltage-divided signal fromVbatt is less than the level of Vref, the signal level at the output ofanalog comparator 46 is low. When the level of the voltage-dividedsignal from Vbatt is greater than level of Vref, the signal level at theoutput of analog comparator 46 is high. Analog comparator 46 hashysteresis to prevent oscillations in its output signal when the levelof the voltage-divided signal from Vbatt is near the level of Vref.

Alarm control 28 is implemented via low-power CMOS logic gates, AND gate38, OR gate 52, and NOT gates 54 and 56. As shown in FIG. 2 the logicgates comprising alarm control 28 are configured such that the output ofalarm control 28 is an alarm signal which is at a high level wheneither: (a) the signal from voltage detector 22 is at a low level andthe signal from pull-up resistor 36 connected to pressure transducer 20is at a high level; or (b) the signal from low power detector 26 is at alow level.

As shown in FIG. 2, the output of alarm control 28 is communicated tothe clock input of positive-edge triggered mono-stable multi-vibrator58, the clock input of negative-edge triggered mono-stablemulti-vibrator 60, and audible indicator 32. Positive-edge triggeredmono-stable multi-vibrator 58 has its output connected to the set inputof visual indicator 30, while negative-edge triggered mono-stablemulti-vibrator 60 has its output connected to the reset input of visualindicator 30. In this configuration, when the alarm signal makes atransition from low (alarm condition not present) to high (alarmcondition present), positive-edge triggered mono-stable multi-vibrator58 applies a pulse to the set input of visual indicator 30, changing thedisplay on visual indicator 30 from the inactive to active state whichindicates to the operator that an alarm condition is present. When thealarm signal changes makes a transition from high to low, negative-edgetriggered mono-stable multi-vibrator 60 applies a pulse to the resetinput of visual indicator 30, changing the display on visual indicator30 from the active to inactive state. The pulse-width and amplitude ofthe pulses produced by positive-edge triggered mono-stablemulti-vibrator 58 and negative-edge triggered mono-stable multi-vibrator60 are configured so the current and voltage supplied to the set andreset inputs of visual indicator 30 is sufficient to cause visualindicator 8 to change state. As shown in FIG. 2, the alarm signal outputfrom alarm control 28 is also communicated to audible indicator 32, apiezoelectric pulse-tone generator which generates an audible alarm whenthe alarm signal is high.

It will be apparent to those skilled in the art that hazard monitor 2may be adapted to integrate with differing designs of prior-arttourniquet systems. For example, if desired, transducer 20 of hazardmonitor 2 may be adapted to connect directly in line with the pneumatictubing between instrument 8 and cuff 4, rather than via a T-pieceadapter as in the preferred embodiment, such that tourniquet instrument8 is pneumatically connected through hazard monitor 2 to tourniquet cuff4.

If desired, hazard monitor 2 may be physically integrated into aprior-art tourniquet instrument, sharing the same physical housing buthaving separate circuitry, power supply and alarms. The hazard monitormay be further adapted by being more fully integrated into certain typesof prior-art tourniquet instruments, by sharing a common battery or somecommon audio-visual alarms or other components to simplify the overalldesign and reduce overall costs. For example, the prior-art tourniquetof McEwen '099 produces a cuff over-pressurization alarm when thedifference between the actual pressure that is sensed in a tourniquetcuff and a reference pressure level selected via the tourniquetinstrument exceeds a cuff over-pressurization limit; in such a prior-arttourniquet, some audible and visible alarm indicators could be used inan adaptation of hazard monitor 2. Also, McEwen '099 employs atourniquet cuff having two pneumatic ports; for overall simplicity andto reduce overall costs, hazard monitor 2 could be adapted to employ oneof these two ports to communicate pneumatically with the cuff todetermine cuff pressurization.

Some prior-art tourniquet instruments have a “soft” electrical powerswitch (“SP” in FIG. 1), typically implemented as a momentary contactmembrane switch or a low current momentary pushbutton switch. Withreference to FIG. 3, such a “soft” electrical power switch SP does notdirectly control the supply of electrical power to the operationalcomponents of the tourniquet instrument but acts to control otherelectrical components, such as shown at 25, that directly control thesupply of electrical power required for operation of the tourniquetinstrument. The hazard monitor of the present invention may be adaptedand integrated with such tourniquet instruments to prevent the powerrequired for the operation of the tourniquet instrument from beinginterrupted if the “soft” power switch SP is actuated by an operator inan attempt to turn the power off at a time when the cuff is pressurized.For example, each of the prior-art A.T.S. 2000 and A.T.S. 750 tourniquetinstruments manufactured by Zimmer Patient Care Division (Dover, Ohio)includes a “soft” electrical power switch which produces an interruptionof electrical power required for operation of the instrument only afterthe operator has initiated the power interruption by actuating the“soft” power switch, and in the case of the A.T.S. 2000 has continued toactuate the “soft” power switch for a continuous period of at least 2sec. The hazard monitor of the present invention could be readilyadapted and integrated with these prior-art tourniquet instruments sothat initiation of a power interruption by the operator actuating the“soft” power switch SP does not produce an interruption of theelectrical power required for the operation of the tourniquet instrument(as shown in FIG. 3) if the presence of pressurized gas in the cuff isdetected by, for example, the above described pressure transducer 20 ofthe adapted and integrated hazard monitor at the time of switchactuation by the operator. The presence (or lack thereof of pressurizedgas in the cuff can be signaled by the transducer 20 as a high (or low)input to an AND gate 38′ as explained above in connection with the gate38 of the alarm control 28 to which the transducer output is alsoapplied (FIG. 2.) The switch SP output serves as the other input to gate38′, and the output of the gate 38′ controls the power-interruptioncomponent 25 mentioned above.

It will also be apparent to those skilled in the art that hazard monitor2 may be adapted to simultaneously monitor two cuffs and one tourniquetinstrument controlling both cuffs, and it will also be apparent thathazard monitor 2 may be adapted to monitor dual-port cuffs andtourniquet instruments connected to those dual-port cuffs. Additionally,it will be appreciated by those skilled in the art that LEDs, LCDs andaudio speakers may be used to implement other forms of visual andaudible alarms perceptible to a human operator of a tourniquetinstrument and others in the vicinity.

I claim:
 1. A method of preventing an operator from interrupting theelectrical power required for the operation of a surgical tourniquetinstrument if the interruption may be hazardous, comprising the stepsof: monitoring a switch of an electrically powered tourniquet instrumentwherein actuation of the switch by an operator initiates an interruptionin the supply of electrical power required for operation of thetourniquet instrument; detecting whether the pressure of gas in apneumatic tourniquet cuff connected to the tourniquet instrument isgreater than a predetermined pressure level when the switch is actuatedby the operator; and preventing the interruption in the supply ofelectrical power if gas having a pressure greater than the predeterminedpressure level is detected in the pneumatic tourniquet cuff when theswitch is actuated.
 2. A surgical tourniquet instrument having a hazardmonitor, comprising: pressure regulator means for producing pressurizedgas over a time period suitably long for the performance of a surgicalprocedure, wherein the pressure regulator means requires the supply ofelectrical power to produce the pressurized gas; power switch means forenabling an operator to initiate an interruption in the supply of theelectrical power required by the pressure regulator means; pneumaticconnector means for enabling the operator to pneumatically connect aninflatable cuff to the pressure regulator means, thereby establishing apassageway to the cuff for the pressurized gas produced by the pressureregulator means; and hazard monitoring means communicating pneumaticallywith the pneumatic connector means for detecting pressurized gas havinga pressure greater than a predetermined pressure level when aninterruption in the supply of electrical power is initiated by theoperator.
 3. The surgical tourniquet instrument of claim 2 wherein thehazard monitoring means further prevents the interruption in the supplyof the electrical power if gas having a pressure greater than thepredetermined pressure level is detected when the interruption in thesupply of the electrical power is initiated by the operator.
 4. Thesurgical tourniquet instrument of claim 2 and including an inflatabletourniquet cuff pneumatically connectable to the pneumatic connectormeans, wherein the cuff is adapted for encircling a patient's limb andapplying pressure to the encircled limb when connected to the connectormeans and inflated with the pressurized gas.